This invention pertains to the art of medical prostheses and more particularly to a prosthesis and method for controlling eustachian tube function, including but not limited to treating an abnormally patulous eustachian tube.
The invention is particularly applicable to a prosthesis disposed in one end of the eustachian tube adjacent the middle ear and will be described with particular reference thereto. However, it will be appreciated that the invention has broader applications and may be advantageously employed in other areas of the eustachian tube.
There is a spectrum of eustachian tube disorders ranging from abnormal chronic closure to abnormal constant patency. Persons suffering from a dysfunctional or chronically closed eustachian tube are exposed to problems related to chronic negative pressure in the middle ear space. Although not exclusive, a list of problems associated with a dysfunctional or chronically closed eustachian tube includes serous otitis media, chronic otitis media, tympanic membrane retraction, cholesteatoma formation and hearing loss. Oftentimes, a dysfunctional or chronically closed eustachian tube is encountered during middle ear surgery.
The Wright, III - U.S. Pat. No. 4,015,607 issued Apr. 5, 1977 describes in greater detail some of the problems and various methods devised for restoring aeration to the middle ear cavity. For purposes of brevity, that patent is hereby incorporated by reference to illustrate other procedures and apparatus used to maintain patency of the eustachian tube.
At the other end of the spectrum of eustachian tube disorders, a person suffering from an abnormally open, or patulous, eustachian tube is exposed to varied annoyances and problems resulting from free communication between the middle ear and the nasopharynx. The patulous eustachian tube is often associated with weight loss, neuromuscular disorders, and other chronic illnesses. The loss of soft tissue surrounding the eustachian tube is thought to be the primary reason for the patulous eustachian tube, although all the causes and reasons for the resulting condition may not be completely understood.
Symptoms associated with the condition include autophony, very simply described as the situation in which a patient hears his own breath and voice. Patients afflicted with a patulous eustachian tube also describe a feeling of fullness or blockage in the ear. In a normal, healthy patient the middle ear is usually maintained at a slightly negative pressure. Those afflicted with the condition under discussion, though, have their middle ear exposed to atmospheric pressure due to the open passageway and free communication with the nasopharynx. Thus, the feeling of fullness or blockage is believed to result from this pressure situation, namely, absence of a slightly negative pressure. Still other symptoms associated with a patulous eustachian tube can be detailed but those noted above are the most common problems associated with this condition.
A number of patients with these patulous eustachian tube symptoms have been diagnosed as neurotic or psychotic as reported by Pulec and Hahn, Jr. in Otolaryngological Clinics of North America, February 1970. Thus, the concern and problems linked with a patulous eustachian tube dictate the need for a reliable solution. The November, 1982 Vol. 108 issue of Archives of Otolaryngology describes in an article by Virtanan and Palva a variety of suggested remidies for a patient suffering from a patulous eustachian tube. Among these include a prescription for weight increase to replace the tissue mass depleted by the weight loss. Another treatment prescribed is insufflation of boric acid and salicylic acid powder into the pharyngeal orifice of the eustachian tube. Yet another treatment involves infusion of an absorbable gelatin sponge solution into the eustachian tube. Still another proposed solution that has met with some limited success is the injection of Teflon material (a registered trademark of E. I. DuPont de Nemours and Company) at the anterior-inferior margin of the eustachian tube orifice. This treatment has been discontinued due to fatal injections of the internal carotid artery. Each of these other treatments has its minor successes but also suffers from various drawbacks.
Those afflicted with a patulous eustachian tube, as well as those treating the condition, consider the above-noted remedies to still fall far short of an adequate solution. Likewise, those persons afflicted with a dysfunctional or chronically closed eustachian tube and those treating the condition find present solutions incomplete. The subject invention is deemed to provide a prosthesis and method that will adequately treat the conditions and overcome the drawbacks associated with the noted remedies.